<?php $this->load->view('vheader')?>
<div class="widget-box">
    <div class="widget-header">
	<h4 style="text-align:center; ">Supplier baru</h4><!-- Ini untuk judul form -->      
    </div>
	<div class="widget-body">
        <div class="widget-main"> 
		
		<table style="width:100%;">
		<tr>
			<td>Nama</td>
			<td>:</td>
			<td><input type="text" name="nama"></td>
		</tr>
		<tr>
			<td>Alamat</td>
			<td>:</td>
			<td><input type="text" name="alamat"></td>
		</tr>
		<tr>
			<td>Kota</td>
			<td>:</td>
			<td><input type="text" name="kota"></td>
		</tr>
		<tr>
			<td>Kode Pos</td>
			<td>:</td>
			<td><input type="text" name="kodepos"></td>
		</tr>
		<tr>
			<td>Telepon</td>
			<td>:</td>
			<td><input type="text" name="tlp"></td>
		</tr>
		<tr>
			<td>Pax</td>
			<td>:</td>
			<td><input type="text" name="fax"></td>
		</tr>
		<tr>
			<td>Contact Person</td>
			<td>:</td>
			<td><input type="text" name="cp"></td>
		</tr>
		<tr>
			<td>E-mail</td>
			<td>:</td>
			<td><input type="text" name="email"></td>
		</tr>
		<tr>
			<td>Nomor-Hp</td>
			<td>:</td>
			<td><input type="text" name="hp"></td>
		</tr>
		<tr>
			<td>jenis supplier</td>
			<td>:</td>
		    <TD><input type="radio" name="pbf">PBF
		    <input type="radio" name="non_pbf">Non PBF(retail)</TD>
		</tr>
		<tr>
			<td>Status PKP</td>
			<td>:</td>
			<td>
			<input type="radio">PKP
			<input type="radio">non PKP
			</td>
		</tr>
		<tr>
			<td>NPWP</td>
			<td>:</td>
			<td><input type="text"></td>
		</tr>
		<tr>
			<td>Tempo Pembayaran</td>
			<td>:</td>
			<td>
			<input type="radio" name="pbf">COD</td>
			<td>
			</td>
		</tr>
		<tr>
			<td colspan="2"></td>
			<td>
				<input type="radio" name="pbf">
				<select>
					<option value="1">1</option>
				</select>
				<select>
					<option value="1">Hari</option>
					<option value="2">Minggu</option>
					<option value="3">Bulan</option>
				</select>
			</td>
		</tr>
		</table>
		
        </div>        
    </div>
</div>
<!-- End -->
<?php $this->load->view('vfooter')?><!-- Dan diakhir ini -->